Aggravation of Anginal Episodes Probably due to Dipyridamole in a Patient with Kawasaki Disease-related Myocardial Infarction

• Published in: Japanese Journal of National Medical Services Vol. 43; no. 3; pp. 342 - 346
• Main Authors: KITABAYASHI, Taeru, MATSUSHITA, Takeji, YAMAGUCHI, Masaji, HIGASHI, Kyoko
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of National Medical Services 1989; 一般社団法人 国立医療学会
• Subjects: coronary steal; ジピリダモール; 川崎病; 狭心痛
• ISSN: 0021-1699; 1884-8729
• DOI: 10.11261/iryo1946.43.342

The patient was an 8-year-old girl, who suffered from Kawasaki disease at the age of 4 years and 5 months. After the acute stage of the disease, she had been well and enjoying her daily life without any complaints. When she became 6 years old, she developed an acute myocardial infarction. She was treated with aspirin, dipyridamole and Ca antagonist. The anginal episodes did not disappear after the acute stage of myocardial infarction. Recently, dipyridamole-induced myocardial ischemia has been demonstrated in animals and humans with coronary artery disease. After administration of the dipyridamole was discontinued, her angina pectoris decreased in frequency. The so-called “coronary steal phenomenon” may play some important roles in the dipyridamole-induced ischemia in this patient. Based on our experience, there may be some possibilities that dipyridamole would not be effective in patients with multiple branch lesions in Kawasaki disease.